1. A 40 year old woman report with the complaint of burning sensation in the mouth. Clinical examination reveals lesions consisting of radiating white striations in a retiform arrangement affecting buccal mucosa, tongue, lips & gingiva bilaterally. An incisional biopsy is suggestive of lichen planus. The following are different clinical forms of lichen planus except:

A. Atrophic lichen planus
B. Hypertrophic lichen planus
C. bullous lichen planus
D. Verrucous lichen planus

Ans:D
Types of oral lichen planus

• Reticular
• Erosive
• Atrophic
• Plaque-like
• Papular
• Bullous

2. Lichenoid reactions are mainly due to:____?

A. intake of certain drugs
B. betel nut chewing
C. cigarette smoking
D. intake of alcohol

Ans:A

3. A young lady presents with white lacy lesions in oral cavity and her proximal nail fold has extended onto the nail bed. What is the likely diagnosis?

A: Candidiasis
B: Psoriasi s
C: Geographic tongue
D: Lichen planus

Ans:D
Explanation: Presence of lacy lesions in the oral cavity and nails with pterygium suggests a diagnosis of Lichen Planus in this patient. It commonly affects young adults. The characteristic skin lesion is pruritic,plane topped, polygonal, purplish papule covered with scanty scales. Buccal mucosa, lips and genitalia are commonly involved. Treatment includes antihistaminics for pruritus and topical steroids for localised lesions. Systemic steroids may be given for widespread disease after ruling out contraindications.

4. Primary lesion in lichen planus is:_____?

A. Macule
B. Papule
C. Vesicle
D. Bulla

ans:B

5. All of the following have non-scarring alopcia, EXCEPT:

A: T. capitis
B: Androgenic alopecia
C: Alopecia areata
D: Lichen planus

Ans:D
Explanation:Lichen Planus is a muco-cutaneous disease of immunological origin. It leads to a characteristic pruritic, papular, violaceous eruption of polygonal shape and is often covered with fine scales. Lichen planus most commonly leads to thick patchy rough, scaly skinthat develops on the flexor surfaces of the upper extremities, around the ankles, in the genital region genitalia, and on the mucous membranes and is itchy in nature. It causes scarring alopecia leading permanent hair damage. Taenia capitis – It is a fungal dermatophyte infection of the scalp and hair caused especially by the Trichophyton and Microsporum. It causes contagious non-scarring alopecia. It causes inflammatory lesions such as pustules, scaling and itching. The hallmark of diagnosis is patches of hair loss with a “black-dot” pattern on examination. The clinical diagnosis is confirmed by mycological examination. Androgenic alopecia – It is an autosomal dominant disorder which is the most common cause of alopecia in both men and women. It causes miniaturisation of the hair follicles which is androgen dependent and caused by scalp dihydrotestosterone. There is a typical shortening of the hair cycle leading to increased numbers of anagen hairs entering the telogen phase and thus leading to premature hair fall. It leads to scarring alopecia. Alopecia areata – It is a inflammatory non-scarring alopecia of auto-immune origin. There is a inappropriate immune response due to the hair follicle associated antigens. The patient presents with well – demarcated patches of reversible hair loss. Histologically there is a typical peribulbar lymphocyte infiltration. The disturbance of hair shaft growth leads to characteristic exclamation point hairs which is the hallmark for diagnosis.

6. Lichen planus:____?

A. Can undergo malignant change
B. Treated only by medication
C. Must be excised
D. Is a idiosyncrasy reaction

Ans:A

7. A young male presented with scaly truncal lesions. O/E genital lesions along with oral ‘lace- like’ lesions are seen. The most likely diagnosis is:

A: Lichen planus
B: Psoriasi s
C: Secondary syphilis
D: Behcet’s disease

Ans:A
Explanation: In oral lichen planus, the characteristic lesions are white striae or papules forming a reticular lace like pattern on the buccal mucosa or lateral margins of the tongue, often with a bilaterally symmetrical distribution

8. Histological clefts in lichen planus are______?

A. Civatte bodies
B. Wickham’s Striae
C. Max – Joseph spaces
D. Auspitz’s sign

Ans:C

9. Scenario: Maliya was diagnosed with Lichen Planus after suffering with flat topped polygonal papules which retains the skin lines.
Assertion: Wickham’s striae are white lines which traverse the surface of the papules.
Reason: A focal decrease in thickness of the granular layer and infiltrate corresponds to the presence of Wickham’s striae.

A: Both Assertion and Reason are true, and Reason is the correct explanation for Assertion
B: Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion
C: Assertion is true, but Reason is false
D: Assertion is false, but Reason is true

Ans:C
Explanation: LP is characterized by shiny, violaceous, flat-topped polygonal papules which retain the skin lines. Wickham’s striae are white lines which traverse the surface of the papules. A focal increase in thickness of the granular layer and infiltrate corresponds to the presence of Wickham’s striae

10. In lichen planus the basal cells which are shrunken with an eosinophilic cytoplasm and with a pyknotic and fragmented nuclei are called____?

A. Tzanck cells
B. Civatte bodies
C. Donovan bodies
D. Rushton bodies

Ans:B